Navigating the Coronavirus Pandemic-Personal thoughts-2 Your Emotional Health in Your Hands

Navigating the Coronavirus Pandemic-Personal thoughts-2
Your Emotional Health in Your Hands

R. Srinivasa Murthy, Professor of Psychiatry(retd)

Following the first blog, there were two responses,that led to choose this topic for the second post.

First of this was from a member of a whatsApp group of persons living with a diagnosis of cancer.
“The numbers are scary, sir…don’t know what to do at this time… Feeling too anxious”

In the mass media, during the day, I heard repeatedly, expressions of distress as follows:
‘This is a life altering experience for me’
‘We are in constant state of fear’
‘Behaviour changes is the biggest challenge’

Second response was: ‘Try to give more positive and assuring vibes to take care of the panic’.

The announcement of economic package is the recognition of the vulnerability of the population and the value of economic support.

Similar to the economic support with livelihood issues, there is need to STRENGTHEN the EMOTIONAL HEALTH of the population.

I will address all of these issues at many levels.

I want to first explain the reason for sharing my personal experience with cancer. It was to communicate that each of us have experienced challenges and there are ways to address the same.

I want to take the help of a quote to make the point of crisis being an opportunity for growth from Mahatma Gandhi.I am reading a book on 1918 Flu (Pale Rider, Laura Spinney,2017). I learnt from the book, about 50-100 million people died. The book, covers Indian experiences of the pandemic in great detail. Interestingly, there is extensive coverage of mental health issues. I will review the book in a later post. I strongly suggest reading this book to understand how the pandemic can change life in all aspects, as we know now.

For the current post, the POSITIVE emotional impact of pandemic can be understood by a statement made, over 102 years back, during the Spanish Flu, by the Father of the Nation, Sri. Mahatma Gandhi:

‘This protracted and first long illness in my life thus afforded me a unique opportunity to examine my principles and to test them’.

Each of us have an opportunity for personal growth, technically referred to as post-traumatic growth.

For example, in the last 24 hours, I have read 3 reports (included separately in the Blog) from America focussing on this problem:
“The stress and anxiety caused by the pandemic can and is having an effect on people’s physical and mental health,”.

American Psychiatric Association, President Bruce Schwartz, M.D., said in a press statement. “During this time, it is important to do what we can to maintain self-care and manage the stress. (emphasis added). I would suggest this for everyone coping at home as well as those who are still in their workplaces by necessity, especially the health care professionals on the front lines of this pandemic.”

Similarly, there are numerous articles from newspapers like The Hindu, the Guardian, NYTimes, magazines like New Yorker, Scientific American, The Atlantic, with the following article titles:
‘Counsellors are reaching COVID 19 patients in Bangalore’;
‘How to cope with anxiety and self- isolation’;
‘Existential Inconvenience’;
‘Tips for surviving even enjoying life under lockdown’ ;
‘Four ways to sleep, when you are anxious’;
‘In times of uncertainity , let nature be your refuge’;
‘ Think about the best care scenario’ ;
‘How to prevent loneliness in a time of social distancing’
‘ In praise of phone call’

Here is how EACH ONE OF US, can TAKE CARE of Our EMOTIONAL HEALTH. This can be seen as EMPOWERMENT.

There are generally, in adverse life situations, there are three challenges to mental health.
First I will call ‘Novelty crisis’ (understanding the change(s); Second ‘Reality crisis’( making lifestyles changes) and third ‘Value crisis’(finding meaning of the adversity).

There are three sets of activities that each of us can take up for better emotional health, namely,
(A) activities for better emotional health;
(B) measures to address tension, low mood, helplessness etc; and
(C) finding meaning of the life experience.

In this post, I will give a brief outline of the 10 skills that will address the above three needs. All of these are evidence based. In the subsequent posts, each of these will be taken in detail, along with evidence, ways to make it part of daily life.

Before moving to the specific actions to PROMOTE EMOTIONAL HEALTH, it is important to take some general initiatives like maintaining the daily routines, take periodic breaks, meeting the basic needs, limit exposure to media( greater the exposure more the emotional impact) and stay connected.

A. Activities for better emotional health(this strengthening you)

1. Exercise: Daily physical activity in any form (eg. about 30 minutes of walking etc) is beneficial for mental health in both preventing and minimising the impact of the pandemic. Remember American Cancer Society, in December 2019, concluded exercise is medicine in cancer care .
2. Sleep: There is evidence of the important role of sleep in maintaining emotional health. 8 hours sleep is ideal. The most important aspect is to set definite timings for going to bed as a routine and strictly follow it.
3. Yoga/Meditation: There is good evidence of the value daily practice of yoga/ meditation for emotional health.
4. Eating healthy food, especially rich in fruits and vegetables.
5. Fun time: It is important to build fun time, in daily life, where the you can find ‘Joy of living’. Make this a family activity, wherever possible. Take up meaningful activities like those activities you had planned to do before but never had time to do them e.g. renovation work, painting, reading a book, writing or developing something, or organising your books etc.

B. Measures to address tension, helplessness etc (overcoming distress)

6. Make a family plan: It is important to address the ‘stress’ as a family. Due to social distancing, all the family being together all of the time, can be stressful. The opportunity can be used positively, by involving every one in the family, in taking decisions and continuously sharing information, and developing strategies to address the needs of the family. There can be also rescheduling family matters( postponing less important activities) and all members getting involved in daily activities like cleaning, cooking etc.
It is important to utilise all available supports. Do not hesitate to fully utilise available state support, NGO support or family/social networks. More the support, less the feeling of helplessness. This is the basis of economic support programmes of the Government.
7. Expression of emotions: Everyone will experience distressing emotions at different times of the pandemic. It is vital to find ‘personal time’ to understand the emotional responses and find opportunities to share with trusted members..
8. Daily writings of thoughts and feelings: This is especially useful, when feelings and thoughts are difficult to express with others. 20 minutes daily writing would decrease the negative thoughts and feelings.
9. Art/ Music: Daily time for drawing, painting, listening to music, dance are good to minimise emotional tension.

C. Finding meaning of the life experience

10. Spirituality: Unexpected life events challenges the world view. India is rich in spiritual resources. This is true in all religions. Most people in India, use various forms of spiritual resources to address difficult situations. The pandemic can be utilised for spiritual growth. Building spirituality as part of daily life, in the form of rituals, reading of religious books and discussion of purpose of life and uncertainties of life help you to understand the uncertainties of the pandemic and not react inappropriately.
Everyone will experience the pandemic in different ways due to their differing life situations. By a process of self-examination, utilising the personal spiritual resources, meaning of life can be discovered. I will recall the quote of Mahatma Gandhi,

‘This protracted and first long illness in my life thus afforded me a unique opportunity to examine my principles and to test them’.

(In the following blogs, each of these 10 measures will be addressed in detail. In addition, you can find much reading, audio and visual material at my Blogpost: Blog: http://myemotionalhealthin.com
Though the focus is on living with cancer, the measures are applicable to the current situation)

When to see a Mental Health Professional:
The above measures for promoting mental health will help most of the people.
However, there will be times when professional help will be needed.

In general, when the symptoms are continuously present, when they are interfering with the daily functioning (daily routines, sleep, work) and when severe symptoms like suicidal ideas are present, it is important to seek professional help.

Here is how EACH ONE OF US, can TAKE CARE of Our Emotional Health.
This can be seen as EMPOWERMENT.

TAKE CARE and STAY SAFE.

( P.S. My sincere thanks to Dr.Bashir Sarwari, from Kabul, Afghanistan for his valuable suggestions , based on his over two decades work in conflict situations).

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